11.06.14
End top-down interference in NHS – King’s Fund
There should be a stronger emphasis on devolution within the NHS and a more proportionate approach to regulation in healthcare, according to a new report by The King’s Fund.
The report, ‘Reforming the NHS from within: beyond hierarchy, inspection and markets’, argues that a new political settlement is needed to clarify the strategic role of ministers in determining funding, establishing priorities and providing accountability to Parliament, and leaves local NHS leaders the space to innovate and lead changes to services.
It has also been suggested that there needs to be a move on from prescriptive, top-down approaches towards locally derived solutions. The report would also like to see a move away from ‘heroic’ pace-setting leadership towards supporting staff to lead change and improvement, and replacing external pressures such as targets and inspection with supporting improvement ‘from within’.
Chris Ham, chief executive at The King’s Fund and the report’s author, said: “Transforming the NHS depends much less on bold strokes and big gestures by politicians than on engaging doctors, nurses and other staff in improving care.
“Our report finds that by learning from high-performing health organisations here and abroad, we can move away from top-down change to locally derived solutions. Above all, change must be underpinned by a commitment to put patients first – this commitment has to come from within organisations and cannot be mandated from outside.”
The report also sets out 11 areas of focus for NHS reform in the future:
- Embrace complementary approaches to reform
- Demarcate the role of politicians
- Promote transparency
- Enable devolution
- Be realistic about inspection and regulation
- See competition as one means to improve care rather than a guiding principle
- Support integration of care
- Promote collaboration
- Strengthen leadership and develop skills for improvement
- Commit to continuous improvement over the longer term
- Focus on organisations and networks
A Department of Health spokesperson told NHE: “Our reforms cut unnecessary red tape and gave doctors and nurses, who know their patients best, the power and freedom to make decisions in the best interests of their local community.”
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